Indirect benefit of vaccinating children to protect the community frominfluenza

Abstract

Background Influenza causes annual, worldwide epidemics of respiratory disease that affects all segments of the population. Mass vaccination of healthy children, who are playing an important role in the transmission of influenza, is promoted to be a complementary approach in prevention and control of influenza. However, lack of published systemic review evidencing the indirect protection of vaccinating healthy children makes the implementation under uncertainty.

Method A systemic review was conducted by computerized bibliographic searches in PubMed and the Cochrane Library identifying the published studies on the effectiveness and cost-effectiveness of vaccinating healthy children to control influenza epidemics by reducing transmission in the community. Any study design with vaccinating healthy children as the intervention versus control group with no influenza vaccine was included. Only outcomes measured on the contacts of children, either the community or household members were considered.

Result Twenty-two articles were selected to be reviewed in this project, in which 17 of them covered the public health benefit of vaccinating healthy children to protect others in the community against influenza, and five of them were economic studies. Overall the result suggested that vaccinating health children produces a public health benefit in protecting others in the community against influenza and that it is a cost-effective measure.

Discussion Targeting vaccines to healthy children should be promoted for optimal vaccine allocation, maximizing the vaccination effectiveness. Community planning on vaccine delivery infrastructure as well as educational and communicational strategies is necessary to improve influenza vaccine coverage. Further well-designed studies such as RCT with larger sample sizes, as well as studies in Hong Kong or other sub-tropical regions should be carried out and included. Moreover, large and population-based studies should be conducted to examine the overall impact of universal childhood influenza immunization.